Hamstring Strains – Rehab Exercises That Work

Eccentric Strengthening, Progressive Agility, and Trunk Stabilization

Man With Hamstring Strain

Come on, push! Just a little faster – go, go, go! You feel good, you’re pushing hard – then the next thing you know, you feel a pull in the back of your thigh and down you go. You just strained your hamstring. Now you’re left to wonder what to do next. How long will you be out? What is the best way to get back? How can you prevent this from happening again?

Let’s answer these questions about hamstring strains and give you some exercises you can get started on during your road to recovery…

One Injury Is Enough

As you likely found out the hard way, hamstring strains are common in high-speed sports 1, like track, rugby, and football. But they also affect dancers and others that perform extreme stretches of the hamstring muscles2.

A big problem among those with hamstring strains is that up to 50% tend to get reinjured 3 – usually within the first 2 weeks after returning to sports 4.

This high re-injury rate suggests that either athletes are returning to their sport too soon, they aren’t properly rehabilitating their injury, or both.

How Should You Properly Rehabilitate a Hamstring Strain?

First, we need to look at how the hamstring was injured in the first place. Hamstring strains during high-speed running happen when your leg is fully straightened in front of you 5 – while the hamstrings are being stretched, but are also contracting to help slow down your leg to get it ready for your foot to hit the ground6.

Studies show that there needs to be balance of strength between your quadriceps muscles in the front of your thigh – which help extend your knee forward – and the hamstring muscles in the back of your thigh7 – which help slow it down. In fact, a 20% strength imbalance can result in a 4x risk of getting injured8.

During rehabilitation, we need to make sure your hamstrings have strong eccentric (a condition where the muscle is lengthening, even while contracting) strength. These types of strengthening exercises as part of a routine have been shown to reduce the incidence of hamstring strains9.”

Other areas to focus on while recovering from injury is a progressive agility and trunk stabilization program. These types of exercises help improve balance and control, while limiting muscle weakening. Also, by loading the muscle gradually, we limit the amount of stretch we place on it, which may help with the healing process10.

Exercises for Hamstring Strain Recovery

Soon after a hamstring strain, when pain levels are high, here’s a safe exercise you can do that will help actiavate your hamstrings with the help of your glutes:

1. Bridges

 

Once the acute phase is over and you can tolerate more aggressive exercises, here’s a great hamstring strengthening exercise:

2. Swiss Ball Hamstring Curls

 

Don’t forget trunk stabilization:

3. Side Planks

 

In addition to these exercises, here are some ideas for a progressive agility program 11:

  • Sidestepping with high knees
  • Grapevine
  • Steps forward and backward over tape line while moving sideways
  • Single leg stance eyes open – progressing to eyes closed
  • Single leg stance windmills
  • Fast feet in-place
  • Symptom-free practice with high speed maneuvers

Once you’re able to perform at a high level again, kick up the intensity with these types of exercises to help with balance control and power 12:

  • Forward-falling running drills
  • Explosive starts
  • High knee marching

Remember that re-injury rates are high upon returning to sports. Therefore, I’d recommend taking it slow. Even if your strength seems back to normal and you feel like you’re in peak condition, take your time. Gradually get back to full-speed and full-contact. Once you are back in the swing of things, I’d also recommend to continue strengthening on your own to make sure your hamstring remains strong – this will help minimize the risk for re-injury13.

Question: What concerns do you have about your hamstring strain? You can leave a comment by clicking here.


  1. Brooks JH, Fuller CW, Kemp SP, Reddin DB. Incidence, risk, and prevention of hamstring muscle injuries in professional rugby union. Am J Sports Med. 2006;34:1297–1306. http://dx.doi. org/10.1177/0363546505286022  ↩
  2. Askling C, Saartok T, Thorstensson A. Type of acute hamstring strain affects flexibility, strength, and time to return to preinjury level. Br J Sports Med. 2006;40:40–44. http://dx.doi. org/10.1136/bjsm.2005.018879  ↩
  3. Askling C, Saartok T, Thorstensson A. Type of acute hamstring strain affects flexibility, strength, and time to return to pre-injury level. Br J Sports Med. 2006;40:40–44. http://dx.doi. org/10.1136/bjsm.2005.018879  ↩
  4. Orchard J, Best TM. The management of muscle strain injuries: an early return versus the risk of recurrence. Clin J Sport Med. 2002;12:3–5  ↩
  5. Garrett WE, Jr. Muscle strain injuries. Am J Sports Med. 1996;24:S2-  ↩
  6. Chumanov ES, Heiderscheit BC, Thelen DG. The effect of speed and influence of individual muscles on hamstring mechanics during the swing phase of sprinting. J Biomech. 2007;40:3555–3562. http://dx.doi.org/10.1016/j. jbiomech.2007.05.026  ↩
  7. Arnason A, Andersen TE, Holme I, Engebretsen L, Bahr R. Prevention of hamstring strains in elite soccer: an intervention study. Scand J Med Sci Sports. 2008;18:40–48. http://dx.doi. org/10.1111/j.1600–0838.2006.00634.x  ↩
  8. Croisier JL, Ganteaume S, Binet J, Genty M, Ferret JM. Strength imbalances and prevention of hamstring injury in professional soccer players: a prospective study. Am J Sports Med. 2008;36:1469–1475. http://dx.doi. org/10.1177/0363546508316764  ↩
  9. Arnason A, Andersen TE, Holme I, Engebretsen L, Bahr R. Prevention of hamstring strains in elite soccer: an intervention study. Scand J Med Sci Sports. 2008;18:40–48. http://dx.doi. org/10.1111/j.1600–0838.2006.00634.x  ↩
  10. Sherry MA, Best TM. A comparison of 2 rehabilitation programs in the treatment of acute hamstring strains. J Orthop Sports Phys Ther. 2004;34:116–125. http://dx.doi.org/10.2519/ jospt.2004.1062  ↩
  11. Sherry MA, Best TM. A comparison of 2 rehabilitation programs in the treatment of acute hamstring strains. J Orthop Sports Phys Ther. 2004;34:116–125. http://dx.doi.org/10.2519/ jospt.2004.1062  ↩
  12. Cameron ML, Adams RD, Maher CG, Misson D. Effect of the HamSprint Drills training programme on lower limb neuromuscular control in Australian football players. J Sci Med Sport. 2009;12:24–30. http://dx.doi.org/10.1016/j. jsams.2007.09.003  ↩
  13. Silder A, et al. Clinical and morphological changes following 2 rehabilitation programs for acute hamstring injuries: a randomized clinical trial. JOSPT. 2013;43(5):284–299.  ↩
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